Bidirectional Barbed Suture Research Articles

Double-Needle Bidirectional Barbed Wire Continuous Layered Suture Technique for Laparoscopic Stage I Common Bile Duct Surgery.

Background: Laparoscopic common bile duct exploration (LCBDE) proves a safe and effective treatment for choledochal stones. After LCBDE, preferred choledochal closure is favored for short- and long-term outcomes compared with t-tube drainage. However, there are no relevant studies on the technique of layered closure of the common bile duct with double-needle bidirectional barbed suture at home and abroad. Materials and Methods: A retrospective study of 37 patients who underwent laparoscopic choledochotomy from January 2021 to October 2023 in our hospital was performed. A continuous layered one-stage suture using two-needle bidirectional barb wire. The primary outcomes were stone clearance, operative time, blood loss, and complications. Secondary outcomes were complications, length of hospitalization, and time to drain removal. Results: During the study period, laparoscopic surgery was successful in all cases, and the initial stones were removed without complications. Conclusion: The treatment of choledocholithiasis with continuous layered one-stage suture with double-needle bidirectional barbed wire after LCBDE is a new convenient and effective treatment in selected patients.

The Effect of Bidirectional Barbed Sutures on the Duration of Common Enterotomy Closure in Intracorporeal Anastomosis.

The adoption of intracorporeal anastomosis in minimally invasive surgery for colon cancer has gradually expanded owing to its many advantages. However, intracorporeal anastomosis has the disadvantage of a longer operative time than extracorporeal anastomosis. One reason that intracorporeal anastomosis takes longer to perform is the closure of the common enterotomy. The present study evaluated the effect of bidirectional barbed sutures on the duration of common enterotomy closure in intracorporeal anastomosis for minimally invasive colectomy. The time required for common enterotomy closure was measured with a simulator using an intestinal model. A two-layer suture with continuous full-thickness suture followed by a continuous serosal-muscular suture was adopted. The time required to close the common enterotomy using two unidirectional barbed sutures and one bidirectional barbed suture was measured five times each. The duration of common enterotomy closure using bidirectional barbed suture was significantly shorter than that using two conventional barbed sutures. Bidirectional barbed sutures are useful for closing the common enterotomy in intracorporeal anastomosis for minimally invasive colectomy.

Simple technique of double-layer enterotomy closure using a bidirectional barbed suture material when performing intracorporeal side-to-side anastomosis in robot-assisted right colectomy for colon cancer.

Simple technique of double-layer enterotomy closure using a bidirectional barbed suture material when performing intracorporeal side-to-side anastomosis in robot-assisted right colectomy for colon cancer.

Comparison of incisional bursting strength of a bidirectional absorbable knotless suture material versus a standard continuous absorbable suture material for closure of the equine linea alba.

To evaluate the use of bidirectional knotless barbed suture material for closure of the equine linea alba. Laboratory study. Adult light horse cadavers (n = 24). A 25 cm incision was made through the linea alba, and a 200 L polyurethane bladder was positioned within the abdomen. The linea alba was closed either using USP2/EP5 bidirectional polydioxanone barbed suture or USP2/EP5 standard polydioxanone suture in a simple continuous pattern. Closure time was recorded for each suture type. The bladder was air-insufflated at 40 L/min, and the pressure at body wall failure recorded. The length of suture used for wound closure and wound failure modes were recorded. Suture length, closure time, bursting pressure, and failure modes were compared using Welch-Aspin t-tests. The incisional bursting pressure was comparable between the two groups (p > .05). Less suture material (p < .01) was required with the barbed suture than the standard suture. Closure time was less for the barbed suture than the standard suture (p < .01). Suture failure was the main failure mode in both groups (83% cases). Closure of the equine linea alba using bidirectional barbed suture material reduced the amount of foreign material in the wound and decreased closure time without compromising incisional strength. Bidirectional barbed suture material could be considered as an alternative to standard suture materials for closure of the equine line alba.

Robotic Hernia Repair using a Barbed Suture.

Barbed sutures became available in the mid-1960's, when a popular bidirectional barbed suture was primarily used by plastic surgeons for skin closure. As laparoscopic surgery became more commonplace, so did the need for intracorporeal sewing, but the challenges of tying sutures under tension became apparent. While surgical devices such as the Endostich™ (Covidien, Dublin, Ireland) aided in overcoming the learning curve for laparoscopic sewing, over time, the introduction of a unidirectional barbed suture helped minimally invasive surgeons overcome the challenges of sewing laparoscopically. It is particularly difficult to secure knots under tension using commonly available monofilament and multifilament sutures. Barbed sutures allow for the distribution of tension along the suture closure without the need for securing knots. However, with the introduction of the daVinci™ robot by Intuitive (Sunnyvale, CA) in 2001, sewing has become easier and more popular with the availability of a 3-dimensional, high-definition view and wristed instruments. As robotic general surgery has become increasingly accepted, it is fitting that the use of a barbed suture in hernia surgery has become critical for primary fascia closure of the hernia defect and various layer closures.

Laparoscopic myomectomy using barbed or conventional sutures

To assess the differences in surgical outcomes between bidirectional barbed suture and conventional suture for myoma bed closure during laparoscopic myomectomy. Study design: Ninety-two patients with one to three symptomatic myomas were randomized in a 1:1 ratio to the barbed suture group or the conventional suture group. Myoma bed was sutured either with barbed suture (STRATAFIX™, Ethicon Inc, USA) or continuous conventional suture with intracorporeal knot tying (Vicryl; Ethicon, USA). The surgeon assessed the degree of suturing difficulty using a visual analog scale ranging from 1 (least difficult suturing) to 10 (most difficult suturing). Results: Suturing with barbed suture was easier than suturing with conventional suture (3.04±1.47 Vs. 4.75± 1.35, P &lt; 0.001). Suturing time of the myoma bed was significantly shorter in the barbed suture group (14.98±4.81 Vs 22.09±6.9 min; P &lt; 0.001). Operative time was comparable between both groups (69.67±17.63 Vs 74.15±19.79 min; P = 0.255). The mean intraoperative blood loss was significantly higher in conventional suture group (337.24±234.15 ml Vs 211.3±107.62; P= 0.002). Conclusion: The barbed suture facilitates suturing of the myoma bed during laparoscopic myomectomy. Compared with conventional suture, barbed suture reduces the time needed to suture the myoma bed and the intraoperative blood loss.&#x0D;

Influence of barbed suture oversew of the transverse staple line during functional end-to-end stapled anastomosis in a canine jejunal enterectomy model.

ObjectiveTo evaluate the influence of barbed suture oversew of the transverse staple line during functional end‐to‐end stapled anastomosis (FEESA) in dogs.Study designRandomized, experimental, ex vivo.Animals or sample populationGrossly normal jejunal segments from 14 adult canine cadavers.MethodsNinety‐eight jejunal segments (n = 14/FEESA group, n = 14 controls) were harvested and randomly assigned to a control group, FEESA + monofilament suture oversew, FEESA + unidirectional barbed suture oversew or FEESA + bidirectional barbed suture oversew. Oversew techniques were performed using a Cushing suture pattern. Initial (ILP) and maximum leakage pressure (MLP), repair time (s), and location of observed leakage were recorded.ResultsNo differences were detected in ILP (p = .439) or MLP (p = .644) respectively between experimental groups. Repairs times using barbed suture were ~ 18% faster (~25 s faster; p < .001) compared to monofilament suture. There was no difference between barbed suture types (p = .697). Mean ILP (p < .001) and MLP (p < .0001) were 6.6x and 5.1x greater respectively in the control group. Leakage location occurred predominately at the crotch of the FEESA in all groups.ConclusionFEESAs closed with a transverse staple line oversew using barbed suture, regardless of barb orientation, were completed faster and resulted in similar resistance to anastomotic leakage compared to monofilament suture.Clinical significanceOversewing the transverse staple line following FEESA using barbed suture offers similar resistance to anastomotic leakage, and may be associated with decreased surgical times in dogs compared to monofilament suture. Further studies are necessary to determine the benefits of barbed suture use in both open and laparoscopic gastrointestinal surgical applications following FEESA in dogs.

Evisceration after vaginal cuff dehiscence: A case report and review

Introduction: Intestinal loop Evisceration (VE) complicates the 35- 67% Of Vaginal Cuff Dehiscence (VCD), constituting a medical emergency. In most cases, it is associated with genital prolapse in postmenopausal women with previous hysterectomy. Clinical case: 94-year-old patient with VE after VCD, associated with prolonged use of pessary as a treatment for vaginal cuff prolapse and enterocele, after laparotomic hysterectomy. Results: Vaginal repair was performed abdominally, due to the size and condition of the eviscerated loops, requiring intestinal resection. An omentum flap was attached to the vaginal cuff to improve healing and to try to occlude the Douglas space. Conclusions: VE requires vaginal, abdominal or mixed repair, generally deferring the definitive treatment of the prolapse to a second stage. We recommend being very careful with vaginal vault closure after any type of hysterectomy, avoiding electrosurgery, infection and bleeding, performing the colporrhaphy with bidirectional barbed suture or two layers with braided suture and facing enough tissue at the suture. Keywords: Vaginal evisceration; Vaginal cuff dehiscence; Complications after hysterectomy; Long-standing pessary.

Use of barbed suture in total hip prosthesis. Prospective randomized study

IntroductionThe correct closure of the surgical wound is an important step in the procedure of a total hip prosthesis implantation, which aims to a correct healing of the wound and minimize the risk of complications.The objective of our study is to determine if the use of a bidirectional barbed suture decreases the closing time after PTC, in the fascial and subcutaneous plane, when compared to the conventional suture polyglactin 910. The hypothesis is that there is no difference in closing time when comparing both sutures. Material and methodProspective single blind randomized study comparing 2 groups: study group with the use of bidirectional continuous barbed suture (Quill®) (Gr.Q) and a control group (Gr.V) using discontinuous polyglactin 91 suture (Vicryl®). Closure was performed in 2 planes (fascia and subcutaneous) simultaneously by 2 surgeons. The exclusion criteria were: previous surgeries on the same hip, revision surgeries, major deformities and allergies to suture components.The variables under study were: 1) fascia closure time, subcutaneous and global, 2) surgical wound infection, and 3) dehiscence. Results82 patients (39 GrQ, 43 GrV) were included. The global closing time was shorter in Gr.Q (5 min 59 s) compared to Gr.V (7.01 min); (p < 0.04). They showed differences in subcutaneous closure; Gr.Q shorter time with a 37 s difference (p = 0.048). Differences in fascial plane were not observed.Superficial infection was observed in 1 GrQ patient and 1 in GrV; 1 case of deep infection in Gr.Q (p = 0.29). One patient presented dehiscence of the wound in Gr.Q (p = 0.3). However, these differences did not show statistical significance. ConclusionsThe use of a barbed suture allows a shorter closing time compared to the conventional one. However, despite this decrease in time, no differences were found in terms of the appearance of infection or wound dehiscence.

Utilización de sutura barbada en prótesis total de cadera. Estudio prospectivo aleatorizado

IntroductionThe correct closure of the surgical wound is an important step in the procedure of a total hip prosthesis implantation (total hip arthroplasty, THA), which aims to a correct healing of the wound and minimize the risk of complications.The objective of our study is to determine if the use of a bidirectional barbed suture decreases the closing time after THA, in the fascial and subcutaneous plane, when compared to the conventional suture polyglactin 910. The hypothesis is that there is no difference in closing time when comparing both sutures. Material and methodProspective single blind randomized study comparing two groups: study group with the use of bidirectional continuous barbed suture (Quill™) (Gr. Q) and a control group (Gr. V) using discontinuous polyglactin 91 suture (Vicryl™). Closure was performed in two planes (fascial and subcutaneous) simultaneously by two surgeons. The exclusion criteria were: previous surgeries on the same hip, revision surgeries, major deformities and allergies to suture components.The variables under study were: 1) fascia closure time, subcutaneous and global; 2) surgical wound infection; and 3) dehiscence. Results82 patients (39 Gr. Q, 43 Gr. V) were included. The global closing time was shorter in Gr. Q (5 min 59 sec) compared to Gr. V (7.01 min), (p < 0.04). They showed differences in subcutaneous closure: Gr. Q shorter time with a 37 seconds difference (p = 0.048). Differences in fascial plane were not observed.Superficial infection was observed in one Gr. Q patient and another in Gr. V; one case of deep infection in Gr. Q (p = 0.29). One patient presented dehiscence of the wound in Gr. Q (p = 0.3). However, these differences did not show statistical significance. ConclusionsThe use of a barbed suture allows a shorter closing time compared to the conventional one. However, despite this decrease in time, no differences were found in terms of the appearance of infection or wound dehiscence.

Biomechanical properties of canine staphylectomies closed with barbed or smooth suture.

To compare the duration of closure and biomechanical properties of staphylectomies closed with absorbable bidirectional barbed suture or smooth monofilament suture in a simple continuous or interrupted pattern STUDY DESIGN: Ex vivo study SAMPLE POPULATION: Soft palates (n = 60) harvested from mesaticephalic canine cadavers METHODS: One centimeter of tissue was excised from the caudal border of each soft palate, and the oral and nasopharyngeal mucosal surfaces were apposed with 2-0 bidirectional Quill Monoderm knotless closure device barbed suture (Q), 3-0 Monocryl in a simple continuous (MC) pattern, or 3-0 Monocryl in a simple interrupted (MI) pattern (n = 20 per group). Duration of closure was compared between groups. Tissues were tested under tension to failure, and mode of failure data were collected by video capture. Closure time was longer for MI closures than for Q and MC closures, with means of 259.9, 215.4, and 196.7 seconds, respectively (P < .0001). No difference was detected in yield force, force to first tissue rupture, maximum force, and energy required for yield and maximum force between groups. Energy to yield was 190.0, 167.8, and 188.95 N-mm for MI, Q, and MC closures, respectively. Biomechanical properties of staphylectomies closed with barbed or smooth sutures did not differ in this cadaveric model. Barbed suture can be considered as an alternative for closure of canine staphylectomies. These results provide evidence to justify additional research to evaluate clinical outcomes in dogs undergoing staphylectomy.

Continuous poliglecaprone suture versus bidirectional barded suture for urethrovesical anastomosis during laparoscopic radical prostatectomy: a single-institute retrospective analysis of Chinese patients.

To compare the outcomes of bidirectional barbed suture and continuous poliglecaprone suture for urethrovesical anastomosis (UVA) during laparoscopic radical prostatectomy (LRP). Single-needle poliglecaprone suture was used for UVA in Group 1 (n=27), and double-needle bidirectional barbed suture was used for UVA (n=27) in Group 2. Age, body mass index (BMI), prostate-specific antigen (PSA) level, prostate volume, operative time, anastomosis time, estimated blood loss, Gleason score, number of hospitalization days, and urinary continence at postoperative month 1, 3, 6, and 12 were analyzed statistically. There were no significant differences in age, BMI, prostate volume, PSA level, Gleason score, and indwelling catheter time between the two groups. However, bidirectional barbed suture was associated with a significantly shorter anastomosis time (P=0.007), operation time (P=0.008) and hospitalization duration (P<0.001), and a significantly lower blood loss volume (P=0.005). At the first-month follow-up, urinary continence was achieved in 5 (19%) and 15 (56%) patients in Group 1 and 2, respectively (P=0.005); postoperative third month: 11 (41%) and 23 (85%) patients in Group 1 and 2 respectively (P=0.001); postoperative sixth month: 21 (78%) and 25 (93%) patients in Group 1 and 2 respectively (P=0.250); postoperative first year: 25 (93%) and 27 (100%) patients in Group 1 and 2 respectively (P=0.471). Multivariate regression analysis showed that anastomosis time (HR =0.636; P<0.001) was an independent predictor of postoperative continence. The current findings show that bidirectional barbed suture for UVA during LRP can shorten UVA time and provide better outcomes in terms of early urinary continence recovery.

The efficacy of bidirectional barbed sutures for incision closure in total knee replacement: A protocol of randomized controlled trial.

Background:Barbed suture is a novel type of suture introduced in different surgical specialties. Nevertheless, its effect in total knee replacement is still unclear in terms of wound complications and cost effectiveness. The purpose of the present work is to evaluate the safety and efficacy of bidirectional barbed suture in reducing postoperative wound complications in the patients undergoing total knee replacement.Methods:This prospective, randomized, and controlled study was performed from January 2017 to December 2018. It was authorized via institutional review committee of Yuebei People's Hospital (GDYB1002189). Hundred participants were divided randomly into 2 groups, namely, control group (n = 50) and the study group (n = 50), respectively. All operations were performed using the Miller-Galante prosthesis (Zimmer; Warsaw, IN). For study groups, the joint capsule (Stratafix1-0) and subcutaneous (Stratafix2-0) and intracutaneous (Stratafix3-0) tissues were sutured by a bidirectional barbed suture. At the end, extra 4 to 5 stitches were made to avoid detachment and incision rupture. For control group: the joint capsule was sutured by a traditional absorbable suture (Ethicon VICRYL∗ Plus 1-0), and the subcutaneous tissue was sutured by an absorbable suture (Ethicon VICRYL∗ Plus 2-0). The skin was sutured by staples. Incision length, suture time, operation time, postoperative length of hospital stay, and incision complications (such as effusion, infection, hematoma, and skin necrosis) were recorded. All data analyses are implemented through utilizing SPSS for Windows Version 20.0.Results:The results will be shown in Table 1.Conclusion:This study can reach a reliable evidence for utilizing bidirectional barbed suture in wound closure in total knee replacement.Trial registration:This study protocol was registered in Research Registry (researchregistry5823).

Comparison between bidirectional Stratafix\xae barbed suture\xa0and conventional suture\xa0in laparoscopic myomectomy: a retrospective study

BackgroundLaparoscopic myomectomy (LM) is one of the techniques feasible for the treatment of intramural myoma. This technique is reported to be difficult when large fibroids are involved because of excessive blood loss during surgery. Skillful and fast suturing appears to be associated with reduced blood loss during LM. In this study we compared the surgical outcomes of using bidirectional Stratafix® barbed suture versus conventional suture during LM.MethodsThis retrospective study included all patients who underwent LM for the treatment of intramural myoma in our institution between 2015 and 2020. The patients were divided into 2 groups according to the technique of suturing during LM: Group 1 comprised patients in whom Stratafix® barbed suture was used (n = 29), and group 2 comprised those in whom conventional suture was used (n = 15). Data of patient age, myoma size, the number of myoma nodes, hemoglobin levels, total operation time, total suturing time, and blood loss during surgery were compared between the 2 groups.ResultsNo significant differences in age (p = 0.463) or myoma size (P = 0.373) were observed between the 2 groups. Operation time (P = 0.0104), suturing time (P = 0.007), and blood loss (P = 0.0375) during surgery were significantly less with Stratafix® barbed suture than with conventional suture. No patient required intraoperative transfusion or conversion to laparotomy.ConclusionThe use of bidirectional barbed suture reduces operation time, suturing time, and blood loss. As these new sutures have barbs, no knot-tying is required; thus, continuous suturing becomes very simple and maintaining hemostasis is easy. Unskilled gynecological surgeons who apply this suture technique can also perform LM easily. As the bidirectional barbed suture has multiple points of fixation, this suture technique can reapproximate tissue securely, which reduces the chances of reoperation because of proper suture knotting. Therefore, bidirectional Stratafix® barbed sutures could be an optimal and efficient alternative to conventional sutures for use by gynecological surgeons in Japan.

Fibrin Sealant Artiss Compared to Progressive Tension Sutures With Stratafix in the Management of Wound Drainage Following Post-Bariatric Body-Contouring Surgery.

Post-bariatric body-contouring surgery is one of the most rapidly growing areas in plastic surgery. One of the most common complications following post-bariatric body-contouring surgery is seroma. There are a number of approaches to reducing wound drainage and seroma formation. A promising strategy to reduce these complications is to develop effective methods for reducing dead space between the tissue layers. We conducted a retrospective trial assessing the use of human fibrin sealant Artiss in comparison to progressive tension sutures (PTS) with Stratafix, a bidirectional barbed suture device in patients undergoing post-bariatric body-contouring surgery. Thirty-six patients for abdominoplasty or lower-body-lift were evaluated. Treatment patients underwent procedure with fibrin sealant applied to adapt the tissue layers. Control patients underwent an identical procedure but with PTS. Primary outcome measures included total wound drainage and time to drain removal. The use of Artiss in abdominoplasty was associated with a mean drain volume that was significantly higher and more days that were needed to remove all drains compared to the PTS group. In body-lift, the mean drain volume and number of days needed to remove all drains tended to be higher when using Artiss compared to the PTS group. The use of Artiss in post-bariatric body-contouring surgery did not decrease the rate of seromas and the length of time required for post-surgical drains when compared to PTS.

Bidirectional knotless barbed versus conventional smooth suture for closure of surgical wounds in inguinal castration in horses

BackgroundCastration of the stallion is one of the most frequently performed surgical procedures in the horse. Recently barbed suture materials for surgical wound closure were introduced to the market with manufacturers claiming that these sutures enhance speed and security as they eliminate the need to tie knots. Recently, it has been suggested that this type of suture may increase postoperative complications. This study aimed at investigating and comparing a bidirectional absorbable knotless barbed suture (KBS) to a conventional smooth suture (SS) for wound closure of inguinal castrations in the horse. This was done by evaluating short-term and post-discharge complications and by comparing the time spent on suturing the surgical wounds after bilateral inguinal castration, which was performed on 45 horses undergoing castration at The Large Animal Teaching Hospital at University of Copenhagen from September 2017 to May 2019.ResultsShort-term complications were few; at 24 h minor swelling occurred in 29 and 33% of horses sutured with KBS and SS respectively and cutaneous dehiscence during recovery occurred in two horses of each group. Post-discharge follow-up revealed that three horses needed veterinary attention for treatment of complications (scrotal swelling (n = 1, KBS); wound exudation (n = 1, SS) and wound dehiscence after return to pasture (n = 1, SS)). Wound closure was achieved 6 min faster with KBS than with SS (P < 0.0001).ConclusionsUse of the KBS suture did not result in increased occurrence of postoperative complications. Wound closure was faster with KBS than with SS in equine bilateral inguinal castration. Our results show that KBS can safely be used in the horse following bilateral inguinal castrations without adverse effects and with a reduction in suturing time.

Are There Lower Complication Rates with Bidirectional Barbed Suture in Total Knee Arthroplasty Incision Closure? A Randomized Clinical Trial

BackgroundThe use of barbed suture in total knee arthroplasty (TKA) remains controversial. We performed a prospective study to investigate the clinical outcomes of bidirectional barbed suture for incision closure in TKA.Material/MethodsWe conducted a single-center, randomized controlled trial to determine the efficiency and safety of barbed suture in TKA at our institution between December 2017 and April 2019. Eligible patients were randomly assigned to different suture methods for skin closure. Randomization was conducted via computerized randomization list. Our primary endpoint was the incidence of wound complications within 3 months of surgery. This trial was registered at ClinicalTrials.gov, number ChiCTR-IPR-17013677.ResultsA total of 582 patients were enrolled, consisting of 193 who received full-layer barbed suture (group A), 195 who received barbed suturing of the joint capsule (group B), and 194 who received suturing of the joint capsule by traditional absorbable suture (group C). The incidence of incision complications in group A (19.7%) was significantly higher than that in group B (7.2%) and C (9.3%) (P<0.0125). The incidence rate for incision complications in group B was similar to that in group C (P>0.0125). The time for incision closure in groups A (13.5±2.0 min) and B (16.1±1.9 min) was significantly shorter than that in group C (25.0±2.0 min) (P<0.001).ConclusionsThe use of full-thickness bidirectional barbed suture for incision closure after TKA may increase postoperative incision complications, and therefore is not recommended. However, the use of barbed suture for the joint capsule has shown effectiveness, reducing suture time with no increase in incision complications.

Comparison of Unidirectional and Bidirectional Barbed Suture in Vaginal Cuff Closure during Total Laparoscopic Hysterectomy- A Randomised Controlled Trial

Comparison of Unidirectional and Bidirectional Barbed Suture in Vaginal Cuff Closure during Total Laparoscopic Hysterectomy- A Randomised Controlled Trial

Posterior muscle-fascial reconstruction and knotless urethro-neo bladder anastomosis during robot-assisted radical cystectomy: Description of the technique and its impact on urinary continence.

The aim of our study is to describe the use of posterior muscle-fascial reconstruction during urethro-ileal anastomosis in bladder cancer (BC) patients submitted to robot-assisted radical cystectomy (RC) with orthotopic neobladder (ON) and its role in facilitating day- and night-time continence recovery during a 12-month follow up. We prospectively collected data from 42 consecutive patients who underwent RARC with totally intracorporeal ON and extended pelvic lymph node dissection (PLND) at our Institution from June 2014 to October 2017. Prior to the urethro-neobladder anastomosis we reconstructed the Denonvilliers Fascia (DF) as previously described for radical prostatectomy using a bidirectional barbed suture. Day and night-time recovery rates were reported at 3, 6 and 12 months after surgery, with continent patients being those using either no urinary pads or 1 safety pads. Median age at surgery was 63 yrs, 41 (97.6%) patients were male. 28 (66.7%) patients presented a clinical T2 disease. Median operative time and median ON reconstruction time were 450 minutes and 180 minutes respectively. 13 (31%) individuals had non-organ confined disease, with 11 (26.2%) patients with positive lymph nodes (median 3 positive lymph nodes) and 2 (4.8%) with non-urothelial cancer at final pathologic examination. Median hospital stay and median catheterization time were 7 (IQR 7-8) and 21 (IQR 19-22). During first 30 post-operative days we recorded 7 (16.7%) low-grade Clavien and 2 (4.8%) IIIa Clavien complications, whereas between 30 and 90 postoperative days we recorded 4 (9.5%) low-grade, 4 (9.5) IIIa and 1 (2.4%) IIIb complications. Day-time and night-time continence rates were 61.9% vs 52.4%, 73.8% vs 64.3% and 90.5% vs 73.8% at three, six and twelve months follow up. Day-time continence was significantly superior in the younger group (97% vs 57%, p 0.01); night-time continence rates were also superior among < 70 yrs patients, despite not reaching statistical significance (77% vs 57%, p 0.3). Posterior muscle-fascial reconstruction aids continence recovery in BC patients undergoing RARC with ON, with younger and fitter patients most benefitting from ON reconstruction.

22: Sacrocolpopexy mesh attachment using bidirectional barbed suture

22: Sacrocolpopexy mesh attachment using bidirectional barbed suture